MEDICARE: SACRED CIRCLE THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1003751702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACRED CIRCLE THERAPY, LLC

Provider Business Mailing Address
First Line	:	1832 KEMPSVILLE RD STE 1121166
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-6861
Country	:	US
Telephone Number	:	757-276-1242
Fax Number	:

Provider Business Practice Location Address
First Line	:	4661 BOXFORD RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-4872
Country	:	US
Telephone Number	:	757-276-1242
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ESTRELLA STANELLE NESBIT
Credential	:
Telephone Number	:	559-308-5186

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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